On the finish of final 12 months, CMS finalized a fee minimize for Medicare reimbursement to physicians. The CMS Truth Sheet states:
…common cost charges beneath the PFS [Physician Fee Schedule] can be decreased by 2.93% in CY 2025, in comparison with the common quantity these companies had been paid for many of CY 2024
This seems like a modest pay minimize, however the American Medical Affiliation the true impression is even bigger. CMS stories that the Medicare Financial Index (MEI)–a measure of observe price inflation from employees salaries and wages, workplace area, provides and malpractice–elevated by 3.5%. Thus, with reimbursement falling and observe price rising the true reimbursement discount is nearer to six.7% actual reimbursement discount.
Why is CMS doing this? MedPAC notes that CMS could also be aiming to drive down reimbursement for physicians in conventional Medicare fee-for-service so as to shift them to superior various cost fashions (A-APM). Whereas the reimbursement differential between FFS and A-APM physicians is only one% in 2027, it can develop to 10.5% over a number of many years.
Traditionally, the Fee has discovered that Medicare beneficiaries had related entry to care relative to the privately insured, however the bigger hole between MEI progress and PFS updates may negatively have an effect on beneficiary entry sooner or later.
Joe Paduda agrees with this evaluation.
